Essa Hariri

Magnetic property, DFT calculation, and biological activity of bis[(μ2-chloro)chloro(1,10-phenanthroline)copper(II)] complex

The dinuclear complex bis[(μ(2)-chloro)chloro(1,10-phenanthroline)copper(II)] (1) was synthesized, and characterized by X-ray, FTIR and thermal analysis. The fitting of magnetic susceptibility and magnetization curve of (1) indicates the occurrence of weak antiferromagnetic exchange interaction between copper(II) ions. The electronic structure has been also determined by density functional theory (DFT) method. Complex (1) displayed potent anticancer activity against B16 (Melanoma), MDA-MB-32 (Breast Adenocarcinoma), A549 (Lung Adenocarcinoma), HT-29 (Colon Adenocarcinoma) and SF (Astrocytoma) cell lines with an average IC50 value of 0.726 μg/ml compared to 4.88 μg/ml for cisplatin. Complex (1) has a better therapeutic index and toxicological profile than cisplatin, and has demonstrated a potential chemotherapeutic property.

Change in Pulse Wave Velocity and Short-Term Development of Cardiovascular Events in the Hemodialysis Population

The association between single measurements of carotid‐femoral pulse wave velocity (cfPWV) and cardiovascular (CV) events is driven by late events beyond 12 months of follow‐up. This prospective study compares single measurements of cfPWV vs the 2‐year delta cfPWV and the association with short‐term development of CV events in hemodialysis patients. cfPWV was performed at t=0 and t=1 two years later, and patients were followed‐up for development of CV events through 12 months (n=66). In Cox regression models adjusted for CV risk factors, history of CV events and delta cfPWV remained associated with the development of CV events (hazard ratio for prior CV events=8.9, P=.03; hazard ratio for delta cfPWV=1.14; P=.002). When delta cfPWV was substituted for single cfPWV measurement, none of the single measures were associated with new CV events. The change in cfPWV, but not single measurements of cfPWV, was associated with the development of CV events through 12 months.

Optimal Duration of Monitoring for Atrial Fibrillation in Cryptogenic Stroke: A Nonsystematic Review

Atrial fibrillation (AF) is the most common form of cardiac arrhythmias and an independent risk factor for stroke. Despite major advances in monitoring strategies, clinicians tend to miss the diagnoses of AF and especially paroxysmal AF due mainly to its asymptomatic presentation and the rather limited duration dedicated for monitoring for AF after a stroke, which is 24 hours as per the current recommended guidelines. Hence, determining the optimal duration of monitoring for paroxysmal atrial fibrillation after acute ischemic stroke remains a matter of debate. Multiple trials were published in regard to this matter using both invasive and noninvasive monitoring strategies for different monitoring periods. The data provided by these trials showcase strong evidence suggesting a longer monitoring strategy beyond 24 hours is associated with higher detection rates of AF, with the higher percentage of patients detected consequently receiving proper secondary stroke prevention with anticoagulation and thus justifying the cost-effectiveness of such measures. Overall, we thus conclude that increasing the monitoring duration for AF after a cryptogenic stroke to at least 72 hours will indeed enhance the detection rates, but the cost-effectiveness of this monitoring strategy compared to longer monitoring durations is yet to be established.

Impact of inflammation, gene variants, and cigarette smoking on coronary artery disease risk

BackgroundThe role of inflammation in coronary artery disease (CAD) pathogenesis is well recognized. Moreover, smoking inhalation increases the activity of inflammatory mediators through an increase in leukotriene synthesis essential in atherosclerosis pathogenesis.AimThe aim of this study is to investigate the effect of “selected” genetic variants within the leukotriene (LT) pathway and other variants on the development of CAD.MethodsCAD was detected by cardiac catheterization. Logistic regression was performed to investigate the association of smoking and selected susceptibility variants in the LT pathway including ALOX5AP, LTA4H, LTC4S, PON1, and LTA as well as CYP1A1 on CAD risk while controlling for age, gender, BMI, family history, diabetes, hyperlipidemia, and hypertension.Resultsrs4769874 (ALOX5AP), rs854560 (PON1), and rs4646903 (CYP1A1 MspI polymorphism) are significantly associated with an increased risk of CAD with respective odds ratios of 1.53703, 1.67710, and 1.35520; the genetic variant rs9579646 (ALOX5AP) is significantly associated with a decreased risk of CAD (OR 0.76163). Moreover, a significant smoking-gene interaction is determined with CYP1A1 MspI polymorphism rs4646903 and is associated with a decreased risk of CAD in current smokers (OR 0.52137).ConclusionThis study provides further evidence that genetic variation of the LT pathway, PON1, and CYP1A1 can modulate the atherogenic processes and eventually increase the risk of CAD in our study population. Moreover, it also shows the effect of smoking-gene interaction on CAD risk, where the CYP1A1 MspI polymorphism revealed a decreased risk in current smokers.

Efficient and Cost-Effective Alternative Treatment for Recurrent Urinary Tract Infections and Interstitial Cystitis in Women: A Two-Case Report

Urinary tract infections (UTIs) are among the most common bacterial infections affecting women. UTIs are primarily caused by Escherichia coli, which increases the likelihood of a recurrent infection. We encountered two cases of recurrent UTIs (rUTIs) with a positive E. coli culture, not improving with antibiotics due to the development of antibiotic resistance. An alternative therapeutic regimen based on parsley and garlic, L-arginine, probiotics, and cranberry tablets has been given. This regimen showed a significant health improvement and symptoms relief without recurrence for more than 12 months. In conclusion, the case supports the concept of using alternative medicine in treating rUTI and as a prophylaxis or in patients who had developed antibiotic resistance.

β-2-himachalen-6-ol: A novel anticancer sesquiterpene unique to the Lebanese wild carrot

Daucus carota ssp. carota, also known as wild carrot, is a commonly used herb in Lebanese folk medicine to treat several ailments including cancer. Previous studies in our laboratories showed that the Daucus carota oil extract (DCOE) and subsequent fractions exhibit antioxidant, anti-inflammatory and anti-cancer activities. In this study, we report the isolation and identification of the major compound responsible for the anti-cancer activity of DCOE along with the mechanism of action involved. GC-MS and NMR spectroscopy revealed the identity of the major compound as β-2-himachalen-6-ol, a novel sesquiterpene unique to the Lebanese wild carrot. β-2-Himachalen-6-ol demonstrated potent anti-cancer activity against B16F-10, Caco-2, MB-MDA-231, A549 and SF-268 cancer cells (IC50 13-4µg/ml; 58-18µM), with SF-268 cells being the most sensitive. The sesquiterpene was shown to induce cell death through apoptosis (flow cytometry), decrease 2D cell motility (wound healing assay) and 3D invasion, as well as increase cell adhesion in SF-268 cells. Additionally, β-2-himachalen-6-ol showed very low toxicity in mice with an LD50>6000mg/kg body weight. In conclusion, the present data demonstrate that β-2-himachalen-6-ol is a potential multi-mechanistic chemotherapeutic drug with high potency and safety.

Sickle cell nephropathy: an update on pathophysiology, diagnosis, and treatment

Sickle cell nephropathy is a major complication of sickle cell disease. It manifests in different forms, including glomerulopathy, proteinuria, hematuria, and tubular defects, and frequently results in end-stage renal disease (ESRD). Different pathophysiologic mechanisms have been proposed to explain the development of nephropathy in SCD, where hemolysis and vascular occlusion are the main contributors in the manifestations of this disease. Markers of renal injury, such as proteinuria and tubular dysfunction, have been associated with outcomes among patients with sickle cell nephropathy and provide means for early detection of nephropathy and screening prior to progression to renal failure. In small-sized clinical trials, hydroxyurea has demonstrated to be effective in slowing the progression to ESRD. Dialysis and renal transplantation represent the last resort for patients with sickle cell nephropathy. Nevertheless, despite the availability of diagnostic and therapeutic strategies, sickle cell nephropathy remains a challenging and under-recognized complication for patients with sickle cell disease.

Twenty-Five-Year (1986-2011) Trends in the Incidence and Death Rates of Stroke Complicating Acute Myocardial Infarction

BACKGROUND The occurrence of a stroke after an acute myocardial infarction is associated with increased morbidity and mortality rates. However, limited data are available, particularly from a population-based perspective, about recent trends in the incidence and mortality rates associated with stroke complicating an acute myocardial infarction. The purpose of this study was to examine 25-year trends (1986-2011) in the incidence and in-hospital mortality rates of initial episodes of stroke complicating acute myocardial infarction. METHODS The study population consisted of 11,436 adults hospitalized with acute myocardial infarction at all 11 medical centers in central Massachusetts on a biennial basis between 1986 and 2011. RESULTS In this study cohort, 159 patients (1.4%) experienced an acute first-ever stroke during hospitalization for acute myocardial infarction. The proportion of patients with acute myocardial infarction who developed a stroke increased through the 1990s but decreased slightly thereafter. Compared with patients who did not experience a stroke, those who experienced a stroke were significantly older, were more likely to be female, had a previous acute myocardial infarction, had a significant burden of comorbidities, and were more likely to have died (32.1% vs 10.8%) during their index hospitalization. Patients who developed a first stroke in the most recent study years (2003-2011) were more likely to have died during hospitalization than those hospitalized during earlier study years. CONCLUSIONS Although the incidence rates of acute stroke complicating acute myocardial infarction remained relatively stable during the years under study, the in-hospital mortality rates of those experiencing a stroke have not decreased.

Pseudo-vanishing lung syndrome in a patient with tricuspid valve bacterial endocarditis

Infective endocarditis is a major cause of morbidity and mortality among individuals with opioid use disorder who use injection drugs. It is frequently associated with tricuspid valve endocarditis and Staphylococcus aureus bacteremia, with secondary pulmonary septic emboli. Herein, we report a unique case of pulmonary cavitation injury following pulmonary septic emboli in the setting of tricuspid valve endocarditis in an injection drug user with opioid use disorder. The pattern of cavitary lung injury mimics radiographically indistinguishable features from vanishing lung syndrome during the most advanced stage of her illness. <Learning objective: This manuscript aims to highlight a new complication of bacterial endocarditis secondary to septic emboli showered from the infected tricuspid valve. This complication, which resembles a pulmonary disease by the name of vanishing lung syndrome, is characterized by extensive pneumatoceles that give the appearance of vanishing lung on chest radiography.>.

Association of waterpipe smoking with myocardial infarction and determinants of metabolic syndrome among catheterized patients

Abstract Background: Waterpipe smoking is a rising global public health epidemic perceived by many users to be less harmful, though its toxicity overlaps or even exceeds that of cigarette smoking. Short-term cardiovascular changes due to waterpipe smoking are well established, but longer-term health impacts are still not fully elucidated. Objective: We aim to investigate the association of waterpipe smoking with myocardial infarction among patients undergoing cardiac catheterization. Methods: The study was performed on Lebanese patients referred for cardiac catheterization. Patient’s blood was collected for metabolic measures and questionnaires were filled out to include socio-demographic, behavioral and pertinent medical characteristics of the study subjects. Results: Myocardial infarction is significantly and independently associated with waterpipe smoking, with odds ratio (OR) of 1.329 (95% CI: [1.04–1.68]; p = .021), which is lower than that for cigarette smoking (OR = 1.87, 95% CI: [1.63–2.15]; p < .001). Only diabetes showed significant association with waterpipe smoking among MI enrollees (OR = 1.66, 95%CI: [1.04–2.63]; p = .032). Conclusion: The study provides yet another evidence for the adverse cardiovascular effects of waterpipe smoking on a clinical level. The harmful effects of waterpipe smoking should be underscored by health care professionals.